title: Case report of an unusual use of lidocaine during episodes of self mutilation.
abstract: We are reporting on a case of polyintoxication by cocaine, lidocaine, methadone, and dextromoramide. This conclusion is supported by the analysis of a strand of hair. We note for the first time the detection of dextromoramide as well as lidocaine and desethyl-lidocaine in hair. Concentrations in hair were: cocaine = 2.4 ng/mg, benzoylecgonine = 0.3 ng/mg, methadone = 10.2 ng/mg, EDDP = 1.5 ng/mg, dextromoramide = 1.6 ng/mg, lidocaine = 115.9 ng/mg and desethyl-lidocaine = 1.6 ng/mg. The victim who was seeking an anesthesia effect without the loss of consciousness ingested cocktails during episodes of self mutilation. The wounds were of two different types and with different morphological locations: long and deep without ablation of tissue, clean lacerations found on the neck, the pectoral region, and the left upper extremity; either round or discoid with deep excavation found on the head (ears, forehead, chin, and lips) and also, on the neck and on the left upper extremity. Near the most recent wounds, needle marks were noticed indicating probable local infiltration of lidocaine.
authors.affiliation: Laboratoire d'Expertises TOXLAB, Paris, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Gaillard
authors.forename: G
authors.initials: G
authors.lastname: Pepin
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000032:analysis; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000032:analysis / Q000494:pharmacology; D001344:Autopsy; D002849:Chromatography, Gas; D003042:Cocaine / Q000008:administration & dosage / Q000032:analysis; D003916:Dextromoramide / Q000008:administration & dosage / Q000032:analysis; D004338:Drug Combinations; D005554:Forensic Medicine; D006197:Hair / Q000737:chemistry; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage* / Q000032:analysis / Q000494:pharmacology; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000032:analysis; D012652:Self Mutilation; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D004338:Drug Combinations; D008012:Lidocaine; D003916:Dextromoramide; D003042:Cocaine; D008691:Methadone